<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01//EN" "http://www.w3.org/TR/html4/strict.dtd">
<html>
<head>
	<title>CPT Audit Tool</title>
</head>

<body>
	<!-- jQuery includes -->
	<script src="js/jquery-1.6.1.js"></script>
	<script src="js/jquery-ui.js"></script>
	<link type="text/css" href="css/jquery-ui.css" rel="Stylesheet" />
	<!-- End jQuery includes -->
	<!-- audit includes -->
	<script src="js/audit.inc.js"></script>
	<link type="text/css" href="css/style.css" rel="Stylesheet" />
	<!-- end audit includes -->
	<script>

		$(function() {

			//dialog to check pt type
			$( "#pttype-dialog" ).dialog({
				autoOpen: false,
				closeOnEscape: false,
				resizable: false,
				height:140,
				modal: true,
				buttons: {
					"New Patient": function() {
						ptType = "new";
						$(".new-pt").show();
						$(".est-pt").hide();
						$(".con-pt").hide();
						$( this ).dialog( "close" );
					},
					"Established Patient": function() {
						ptType = "est";
						$(".new-pt").hide();
						$(".est-pt").show();
						$(".con-pt").hide();
						$( this ).dialog( "close" );
					},
					"Consult": function() {
						ptType = "con";
						$(".new-pt").hide();
						$(".est-pt").hide();
						$(".con-pt").show();
						$( this ).dialog( "close" );
					}
				}
			});

			// initialize tabs view for document
			$( "#audit-body" ).tabs();
			// change checkboxes into button objects
			$( "input[type=checkbox]" ).button();
			// same for all links with button class
			$( ".button" ).button();
		});
		
		//document is ready...
		$(document).ready(function(){
			
			$( "#pttype-dialog" ).dialog('open');

			// reset the form for a new pt
			// is there a better way? maybe use the pttype modal dialog to reset as well?
			$("a#reset").click(function(){
				//uncheck all boxes and remove active button appearance
				$("input[type=checkbox]").attr('checked', false);
				$("input[type=checkbox]").button("refresh")
				// set all dropdowns back to 0
				$( '#mdm select' ).val('0');
				//remove all box highlighting
				$("td").css("background-color", "");
				// move focus back to history tab
				$( '#audit-body' ).tabs('select', '#history');
				// re-call patient type dialog
				$( "#pttype-dialog" ).dialog('open');
				return false;
			});
			
			// evaluate the form and generate cpt code
			$("a#eval").click(
				function(){
					evalLevels();
				}
			);


			//whenever a history checkbox is clicked, recalc the history level
			$("#history input[type=checkbox]").click(
				function(){
					//checkHisLevel();
					colorHisLevel();
				}
			);

			// whenever an exam checkbox is clicked, recalc the exam level
			$("#exam input[type=checkbox]").click(
				function(){
					//countExamSystem();
					colorExamLevel();
				}
			);

			// whenever an mdm select box is changed, recalc the mdm level
			$("#mdm select").change(
				function(){
					//colorMdmLevel();
					colorMdmLevel();
				}
			);

			// whenever a risk table is selected, recalc the mdm level
			$("#mdm_risk td").toggle(
				function(){
					//odd clicks
					$(this).children("input[type=checkbox]").attr('checked', true);
					$(this).css('background-color', 'red');
					colorMdmLevel();
				},
				function(){
					//even clicks
					$(this).children("input[type=checkbox]").attr('checked', false);
					$(this).css('background-color', '');
					colorMdmLevel();
				}
			);

		});
	</script>
	<!-- begin dialog box to query patient type -->
	<div id="pttype-dialog" title="Select Patient Type">
		<p><span class="ui-icon ui-icon-alert" style="float:left; margin:0 7px 20px 0;"></span>Please select the patient type</p>
	</div>
	<!-- end dialog box -->

	<div id="content" >
		<!-- Begin tabs definition -->
		<div id="audit-body" style="margin:auto; position:absolute; top:25px; bottom:152px; width:85%; overflow:auto;">
			<ul>
				<li><a href="#history">History</a></li>
				<li><a href="#exam">Exam</a></li>
				<li><a href="#mdm">MDM</a></li>
			</ul>

			<!-- Section 1: History -->
			<div id="history">
				<div id="hpi" style="margin-top:7px; padding:10px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">History of Present Illness</h4>
					<input type="checkbox" name="hpi_location" id="hpi_location" /><label for="hpi_location">Location</label>
					<input type="checkbox" name="hpi_quality" id="hpi_quality" /><label for="hpi_quality">Quality</label>
					<input type="checkbox" name="hpi_severity" id="hpi_severity" /><label for="hpi_severity">Severity</label>
					<input type="checkbox" name="hpi_modfactors" id="hpi_modfactors" /><label for="hpi_modfactors">Mod Factors</label><br />
					<input type="checkbox" name="hpi_duration" id="hpi_duration" /><label for="hpi_duration">Duration</label>
					<input type="checkbox" name="hpi_timing" id="hpi_timing" /><label for="hpi_timing">Timing</label>
					<input type="checkbox" name="hpi_context" id="hpi_context" /><label for="hpi_context">Context</label>
					<input type="checkbox" name="hpi_signssymp" id="hpi_signssymp" /><label for="hpi_signssymp">Signs/Symp</label>
					<table id="hpi_results" style="float:right;" class="hidden">
						<tr>
							<td class="hpi_prob-foc">1-3 qualifiers</td>
							<td class="hpi_expand-pf">1-3 qualifiers</td>
							<td class="hpi_detailed">4+ qualifiers</td>
							<td class="hpi_comp">4+ qualifiers</td>
						</tr><tr>
							<td class="hpi_prob-foc">PROB FOC</td>
							<td class="hpi_expand-pf">EXPAND PF</td>
							<td class="hpi_detailed">DETAILED</td>
							<td class="hpi_comp">COMP</td>
						</tr>
					</table>
				</div>
				<div id="ros" style="margin-top:7px; padding:10px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Review of Symptoms</h4>
					<input type="checkbox" name="ros_constitution" id="ros_constitution" /><label for="ros_constitution">Constitution</label>
					<input type="checkbox" name="ros_eyes" id="ros_eyes" /><label for="ros_eyes">Eyes</label>
					<input type="checkbox" name="ros_enmt" id="ros_enmt" /><label for="ros_enmt">ENM&amp;T</label>
					<input type="checkbox" name="ros_cardiovas" id="ros_cardiovas" /><label for="ros_cardiovas">Cardiovas</label>
					<input type="checkbox" name="ros_hemalymp" id="ros_hemalymp" /><label for="ros_hemalymp">Hema/Lymph</label><br />
					<input type="checkbox" name="ros_respiratory" id="ros_respiratory" /><label for="ros_respiratory">Respiratory</label>
					<input type="checkbox" name="ros_gi" id="ros_gi" /><label for="ros_gi">GI</label>
					<input type="checkbox" name="ros_gu" id="ros_gu" /><label for="ros_gu">GU</label>
					<input type="checkbox" name="ros_mskeletal" id="ros_mskeletal" /><label for="ros_mskeletal">M-skeletal</label>
					<input type="checkbox" name="ros_allergyimm" id="ros_allergyimm" /><label for="ros_allergyimm">Allergy/Imm</label><br />
					<input type="checkbox" name="ros_skinbreast" id="ros_skinbreast" /><label for="ros_skinbreast">Skin/Breast</label>
					<input type="checkbox" name="ros_neurologic" id="ros_neurologic" /><label for="ros_neurologic">Neurologic</label>
					<input type="checkbox" name="ros_psychiatric" id="ros_psychiatric" /><label for="ros_psychiatric">Psychiatric</label>
					<input type="checkbox" name="ros_endocrine" id="ros_endocrine" /><label for="ros_endocrine">Endocrine</label><br />
					<input type="checkbox" name="ros_other" id="ros_other" /><label for="ros_other">All other sys (means 10 systems were queried)</label>
					<table id="ros_results"  style="float:right;" class="hidden">
						<tr>
							<td class="ros_prob-foc">No ROS in the medical record</td>
							<td class="ros_expand-pf">1 system</td>
							<td class="ros_detailed">2-9 systems</td>
							<td class="ros_comp">ROS of 10 to 14 systems</td>
						</tr><tr>
							<td class="ros_prob-foc">PROB FOC</td>
							<td class="ros_expand-pf">EXPAND PF</td>
							<td class="ros_detailed">DETAILED</td>
							<td class="ros_comp">COMP</td>
						</tr>
					</table>
				</div>
				<div id="pfsh" style="margin-top:7px; padding:10px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Past medical, past family, and past social history</h4>
					<input type="checkbox" name="pfsh_pastmedhx" id="pfsh_pastmedhx" /><label for="pfsh_pastmedhx">Past Med Hx</label>
					<input type="checkbox" name="pfsh_pastfamhx" id="pfsh_pastfamhx" /><label for="pfsh_pastfamhx">Past Fam Hx</label>
					<input type="checkbox" name="pfsh_pastsochx" id="pfsh_pastsochx" /><label for="pfsh_pastsochx">Past Soc Hx</label>
					<table id="pfsh_results" style="float:right; clear:right;" class="hidden">
						<tr class="new-pt">
							<td>New Patient or Initial</td>
							<td class="pfsh_prob-foc">No PFSH</td>
							<td class="pfsh_expand-pf">No PFSH</td>
							<td class="pfsh_detailed">1 history</td>
							<td class="pfsh_comp">3 of 3 Hx's</td>
						</tr><tr class="est-pt">
							<td>Established Patient</td>
							<td class="pfsh_prob-foc">No PFSH</td>
							<td class="pfsh_expand-pf">No PFSH</td>
							<td class="pfsh_detailed">1 history</td>
							<td class="pfsh_comp">2 of 3 Hx's</td>
						</tr><tr>
							<td>&nbsp;</td>
							<td class="pfsh_prob-foc">PROB FOC</td>
							<td class="pfsh_expand-pf">EXPAND PF</td>
							<td class="pfsh_detailed">DETAILED</td>
							<td class="pfsh_comp">COMP</td>
						</tr>
					</table>
				</div>
			</div>
			<!-- End of Section 1. History -->

			<!-- Section 2. Exam -->
			<div id="exam">
				<div id="musc" style="margin-top:7px; padding:10px; width:48%; float:left; height:210px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Musculoskeletal</h4>
						<input type="checkbox" name="musc" id="musc_1" /><label for="musc_1">Musculoskeletal</label>
				</div>
				<div id="cons" style="margin-top:7px; padding:10px; width:48%; float:right; height:210px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Constitution</h4>
						<input type="checkbox" name="cons" id="cons_1" /><label for="cons_1">Measure any 3 of 7 vital signs</label>
						<input type="checkbox" name="cons" id="cons_2" /><label for="cons_2">General appearance</label>
				</div>
				<div id="skin" style="margin-top:7px; padding:10px; width:48%; float:left; height:210px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Skin</h4>
						<input type="checkbox" name="skin" id="skin_1" /><label for="skin_1">Inspection of skin and subcutaneous</label>
						<input type="checkbox" name="skin" id="skin_2" /><label for="skin_2">Palpate skin and subcutaneous tissue</label>
				</div>
				<div id="psy" style="margin-top:7px; padding:10px; width:48%; float:right; height:210px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Psychiatric</h4>
						<input type="checkbox" name="psy" id="psy_1" /><label for="psy_1">Orient time, place, and person</label>
						<input type="checkbox" name="psy" id="psy_2" /><label for="psy_2">Recent and remote memory</label>
						<input type="checkbox" name="psy" id="psy_3" /><label for="psy_3">Mood and affect</label>
						<input type="checkbox" name="psy" id="psy_4" /><label for="psy_4">Judgment and insight</label>
				</div>
				<div id="card" style="margin-top:7px; padding:10px; width:48%; float:left; height:210px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Cardiovascular</h4>
						<input type="checkbox" name="card" id="card_1" /><label for="card_1">Ascultation of heart</label>
						<input type="checkbox" name="card" id="card_2" /><label for="card_2">Palpation of heart (loc, size, thrills)</label>
						<input type="checkbox" name="card" id="card_3" /><label for="card_3">Carotid art (wave, pulse, bruits)</label>
						<input type="checkbox" name="card" id="card_4" /><label for="card_4">Abdominal aorta (sz, bruits)</label>
						<input type="checkbox" name="card" id="card_5" /><label for="card_5">Femoral arteries (size, bruits)</label>
						<input type="checkbox" name="card" id="card_6" /><label for="card_6">Pedal pulses (pulse amplitude)</label>
						<input type="checkbox" name="card" id="card_7" /><label for="card_7">Extremities (edema/varicosities)</label>
				</div>
				<div id="neur" style="margin-top:7px; padding:10px; width:48%; float:right; height:210px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Neurologic</h4>
						<input type="checkbox" name="neur" id="neur_1" /><label for="neur_1">Cranial nerves notation of deficits</label>
						<input type="checkbox" name="neur" id="neur_2" /><label for="neur_2">DTRs</label>
						<input type="checkbox" name="neur" id="neur_3" /><label for="neur_3">Sensation</label>
				</div>
				<div id="eye" style="margin-top:7px; padding:10px; width:48%; float:left; height:210px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Eye</h4>
						<input type="checkbox" name="eye" id="eye_1" /><label for="eye_1">Inspect conjunctivae and lids</label>
						<input type="checkbox" name="eye" id="eye_2" /><label for="eye_2">Exam of pupils and irises</label>
						<input type="checkbox" name="eye" id="eye_3" /><label for="eye_3">Opth-scope ex discs (sz, C/D, app)</label>
				</div>
				<div id="ent" style="margin-top:7px; padding:10px; width:48%; float:right; height:210px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">ENT and Mouth</h4>
						<input type="checkbox" name="ent" id="ent_1" /><label for="ent_1">External ear and nose</label>
						<input type="checkbox" name="ent" id="ent_2" /><label for="ent_2">Otoscopic of ext. canals and TMs</label>
						<input type="checkbox" name="ent" id="ent_3" /><label for="ent_3">Assessment of hearing (t fork, rub)</label>
						<input type="checkbox" name="ent" id="ent_4" /><label for="ent_4">Inspect lips, teeth and gums (and pal)</label>
						<input type="checkbox" name="ent" id="ent_5" /><label for="ent_5">Nasal mucosa, septum, turbinates</label>
						<input type="checkbox" name="ent" id="ent_6" /><label for="ent_6">Exam of oropharaynx</label>
				</div>
				<div id="neck" style="margin-top:7px; padding:10px; width:48%; float:left; height:210px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Neck</h4>
						<input type="checkbox" name="neck" id="neck_1" /><label for="neck_1">Exam neck</label>
						<input type="checkbox" name="neck" id="neck_2" /><label for="neck_2">Exam of thyroid</label>
				</div>
				<div id="resp" style="margin-top:7px; padding:10px; width:48%; float:right; height:210px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Respiratory</h4>
						<input type="checkbox" name="resp" id="resp_1" /><label for="resp_1">Auscultation of lungs</label>
						<input type="checkbox" name="resp" id="resp_2" /><label for="resp_2">Assessment of respiratory effort</label>
						<input type="checkbox" name="resp" id="resp_3" /><label for="resp_3">Percussion of chest</label>
						<input type="checkbox" name="resp" id="resp_4" /><label for="resp_4">Palpation of chest</label>
				</div>
				<div id="ches" style="margin-top:7px; padding:10px; width:48%; float:left; height:210px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Chest</h4>
						<input type="checkbox" name="ches" id="ches_1" /><label for="ches_1">Inspection of the breast</label>
						<input type="checkbox" name="ches" id="ches_2" /><label for="ches_2">Palpation of the breast</label>
				</div>
				<div id="gast" style="margin-top:7px; padding:10px; width:48%; float:right; height:210px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Gastrointestinal</h4>
						<input type="checkbox" name="gast" id="gast_1" /><label for="gast_1">Abdomen/masses tenderness</label>
						<input type="checkbox" name="gast" id="gast_2" /><label for="gast_2">Exam liver and spleen</label>
						<input type="checkbox" name="gast" id="gast_3" /><label for="gast_3">Exam for hernia</label>
						<input type="checkbox" name="gast" id="gast_4" /><label for="gast_4">Anus, perineum, rectum</label>
						<input type="checkbox" name="gast" id="gast_5" /><label for="gast_5">Obtain stool for occult blood pm</label>
				</div>
				<div id="genm" style="margin-top:7px; padding:10px; width:48%; float:left; height:210px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Genitourinary Male</h4>
						<input type="checkbox" name="genm" id="genm_1" /><label for="genm_1">Scrotal contents (lesions, cysts, rash)</label>
						<input type="checkbox" name="genm" id="genm_2" /><label for="genm_2">Penis (lesions, plaque, masses, scar)</label>
						<input type="checkbox" name="genm" id="genm_3" /><label for="genm_3">Digital rectal exam of prostate</label>
				</div>
				<div id="genf" style="margin-top:7px; padding:10px; width:48%; float:right; height:210px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Genitourinary Female</h4>
						<input type="checkbox" name="genf" id="genf_1" /><label for="genf_1">Ext. genitalia (gen, hair dist, lesions)</label>
						<input type="checkbox" name="genf" id="genf_2" /><label for="genf_2">Urethra (masses, tenderness, scar)</label>
						<input type="checkbox" name="genf" id="genf_3" /><label for="genf_3">Bladder (fullness, masses, tender)</label>
						<input type="checkbox" name="genf" id="genf_4" /><label for="genf_4">Cervix (gen appear, lesions, dc)</label>
						<input type="checkbox" name="genf" id="genf_5" /><label for="genf_5">Uterus (sz, contour, position, tender)</label>
						<input type="checkbox" name="genf" id="genf_6" /><label for="genf_6">Adnexa/parametria (ms, tend, nod)</label>
				</div>
				<div id="lymp" style="margin-top:7px; padding:10px; width:48%; float:left; height:210px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Lymphatic</h4>
						<input type="checkbox" name="lymp" id="lymp_1" /><label for="lymp_1">Palpate 2 - neck, ax, groin, other</label>
				</div>
				<div>&nbsp;</div>
			</div>
			<!-- End of Section 2. Exam -->

			<!-- Section 3. MDM -->
			<div id="mdm">
				<div id="mdm_dxmgmt" style="margin-top:7px; padding:10px; width:48%; float:left; height:445px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header"># Dx and Management Options</h4>
						<strong><i>Is today's poblem new to you/your chart? If so, is it...</i></strong><br />
						<label for="dxmgmt_1">Self limiting/minor prob - 1 pt = 1 prob; 2pts = multi</label><br />
							<select id="dxmgmt_1" class="ui-widget-content" name="dxmgmt_1">
								<option value="0">0</option>
								<option value="1">1</option>
								<option value="2">2</option>
							</select><br />
						<label for="dxmgmt_2">New prob(s) no + workup - 3 pts (3 pts max)</label><br />
							<select id="dxmgmt_2" class="ui-widget-content" name="dhmgmt_2">
								<option value="0">0</option>
								<option value="3">3</option>
							</select><br />
						<label for="dxmgmt_3">New prob(s) workup needed - 4 pts (4 pts max)</label><br />
							<select id="dxmgmt_3" class="ui-widget-content" name="dxmgmt_3">
								<option value="0">0</option>
								<option value="4">4</option>
							</select><br />
						<strong><i>Is/Are established problem(s) stable or worsening today?</i></strong><br />
						<label for="dxmgmt_4">Estab prob stable/improved - 1 pt X # of probs</label><br />
							<select id="dxmgmt_4" class="ui-widget-content" name="dxmgmt_4">
								<option value="0">0</option>
								<option value="1">1</option>
								<option value="2">2</option>
								<option value="3">3</option>
								<option value="4">4</option>
								<option value="5">5</option>
							</select><br />
						<label for="dxmgmt_5">Estab prob worsening - 2 pts X # of probs</label><br />
							<select id="dxmgmt_5" class="ui-widget-content" name="dxmgmt_5">
								<option value="0">0</option>
								<option value="2">2</option>
								<option value="4">4</option>
								<option value="6">6</option>
								<option value="8">8</option>
							</select><br />
				</div>
				<div id="mdm_amtcmp" style="margin-top:7px; padding:10px; width:48%; float:right; height:445px;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Amt and Complex Data</h4>
						<label for="amtcmp_1">Review reports/order labs</label><br />
							<select id="amtcmp_1" class="ui-widget-content" name="amtcmp_1">
								<option value="0">0</option>
								<option value="1">1</option>
							</select><br />
						<label for="amtcmp_2">Review/order X-ays</label><br />
							<select id="amtcmp_2" class="ui-widget-content" name="amtcmp_2">
								<option value="0">0</option>
								<option value="1">1</option>
							</select><br />
						<label for="amtcmp_3">Review order dx test</label><br />
							<select id="amtcmp_3" class="ui-widget-content" name="amtcmp_3">
								<option value="0">0</option>
								<option value="1">1</option>
							</select><br />
						<label for="amtcmp_4">Discuss above w/perform MD</label><br />
							<select id="amtcmp_4" class="ui-widget-content" name="amtcmp_4">
								<option value="0">0</option>
								<option value="1">1</option>
							</select><br />
						<label for="amtcmp_5">Dec old rec/hx fom other</label><br />
							<select id="amtcmp_5" class="ui-widget-content" name="amtcmp_5">
								<option value="0">0</option>
								<option value="1">1</option>
							</select><br />
						<label for="amtcmp_6">Looked at film/spec/trace</label><br />
							<select id="amtcmp_6" class="ui-widget-content" name="amtcmp_6">
								<option value="0">0</option>
								<option value="2">2</option>
							</select><br />
						<label for="amtcmp_7">Review records w/summary; other hx; discussed case with othe healthcare provider</label><br />
							<select id="amtcmp_7" class="ui-widget-content" name="amtcmp_7">
								<option value="0">0</option>
								<option value="2">2</option>
							</select><br />
				</div>
				<div id="mdm_risk" style="margin-top:7px; padding:10px; width:99%; float:left;" class="ui-widget ui-widget-content ui-widget-corners-all">
					<h4 class="ui-widget-header">Risk for Complications, morbidity or mortality</h4>
					<table>
						<thead>
							<tr>
								<th width="33%" scope="col">If your patient has...</th>
								<th width="33%" scope="col">If you are going to order...</th>
								<th width="33%" scope="col">If the treatment plan is like...</th>
							</tr>
						</thead>
						<tbody>
							<tr class="high">
								<td id="mdm_high-ill"><input type="checkbox" style="display:none;" id="high" /><ul>
									<li>1 or more chronic illnesses w/severe exacerbation acute/chronic illness that is life or bodily function theatening</li>
									<li>abrupt change in neuro status (weak, sensation loss, TIA)</li>
								</ul></td>
								<td id="mdm_high-ord"><input type="checkbox" style="display:none;" id="high" /><ul>
									<li>CV imaging w/contrast &amp; risk factors</li>
									<li>electrophysiological tests</li>
									<li>dx endoscopies with identified risk factors</li>
									<li>discography</li>
								</ul></td>
								<td id="mdm_high-trt"><input type="checkbox" style="display:none;" id="high" /><ul>
									<li>elective/emergent maj surg w/risk factors</li>
									<li>parenteral controlled substances</li>
									<li>drug therapy w/intensive monitor for toxicity</li>
									<li>decision DNS/deescalate care re: prognosis</li>
								</ul></td>
							</tr><tr class="mod">
								<td id="mdm_mod-ill"><input type="checkbox" style="display:none;" id="mod" /><ul>
									<li>1 or more chronics with mild exacerbation, side effects 2 or more stable chronic illnesses</li>
									<li>undiagnosed new problem with uncertain outcome</li>
									<li>acute illness with systemic symptoms (pyelonephritis, pneumonitis, colitis)</li>
									<li>acute complicated injury (head inj w/brief LOC)</li>
								</ul></td>
								<td id="mdm_mod-ord"><input type="checkbox" style="display:none;" id="mod" /><ul>
									<li>physiologic stress test (card stress, FCST)</li>
									<li>diagnostic endoscopies with no identified risk</li>
									<li>deep needle or incisional biopsy</li>
									<li>CV imaging with contrast and no risk factors</li>
									<li>obtain fluid from body cavity</li>
								</ul></td>
								<td id="mdm_mod-trt"><input type="checkbox" style="display:none;" id="mod" /><ul>
									<li>elective major sugery with no identified risk factors</li>
									<li>minor surgery with identified risk factors</li>
									<li>IV fluids with additives</li>
									<li>prescription drug management</li>
									<li>closed TX nondisplaced fracture</li>
								</ul></td>
							</tr><tr class="low">
								<td id="mdm_low-ill"><input type="checkbox" style="display:none;" id="low" /><ul>
									<li>2 or more self-limiting/minor problems</li>
									<li>1 stable chronic illness (well-controlled HTN</li>
									<li>acute uncomplicated illness or injury (cystitis, allergic rhinitis)</li>
								</ul></td>
								<td id="mdm_low-ord"><input type="checkbox" style="display:none;" id="low" /><ul>
									<li>physiologic tests w/o stress (PFTs)</li>
									<li>Non-CV image w/contast (BE)</li>
									<li>Superficial needle biopsy or skin biopsy</li>
									<li>Lab requiing arterial puncture</li>
								<td id="mdm_low-trt"><input type="checkbox" style="display:none;" id="low" /><ul>
									<li>over-the-counter drugs</li>
									<li>minor surgery no identified risk factors</li>
									<li>Physical Therapy or Occ. Therapy</li>
									<li>IV fluids without additives</li>
							</tr><tr class="min">
								<td id="mdm_min-ill"><input type="checkbox" style="display:none;" id="min" /><ul>
									<li>1 self-limiting or minor problem (cold, tinea corporis)</li>
								</ul></td>
								<td id="mdm_min-ord"><input type="checkbox" style="display:none;" id="min" /><ul>
									<li>Typical labs, X-ay, EKG, US</li>
								</ul></td>
								<td id="mdm_min-trt"><input type="checkbox" style="display:none;" id="min" /><ul>
									<li>rest, gargles, Ace dressing</li>
								</ul></td>
							</tr>
						</tbody>
					</table>
				</div>
			</div>
		<!-- End of Section 3. MDM -->
			
		</div>
		<!-- End of tabs definition -->
	</div>
	<div style="margin-top:7px; padding:10px; position:absolute; height:150px; bottom:0px; width:85%" class="ui-widget-content">
		<div style="float:right; clear:both;">
			<strong><a href="#" id="reset" class="button">Reset Form</a></strong><br />
			<strong><a href="#" id="eval" class="button">Evaluate Form</a></strong>
		</div>
		<table id="final-results">
			<tr id="final-his">
				<!-- History -->
				<td>History</td>
				<td class="his_level-1">Prob Focused</td>
				<td class="his_level-2">Exp Prob Foc</td>
				<td class="his_level-2">Exp Prob Foc</td>
				<td class="his_level-3">Detailed</td>
				<td class="his_level-3">Detailed</td>
				<td class="his_level-4">Comprehensive</td>
				<td class="his_level-4">Comprehensive</td>
			</tr>
			<tr id="final-exam">
				<!-- Exam -->
				<td>Exam</td>
				<td class="exam_level-1">Prob Focused</td>
				<td class="exam_level-2">Exp Prob Foc</td>
				<td class="exam_level-2">Exp Prob Foc</td>
				<td class="exam_level-3">Detailed</td>
				<td class="exam_level-3">Detailed</td>
				<td class="exam_level-4">Comprehensive</td>
				<td class="exam_level-4">Comprehensive</td>
			</tr>
			<tr id="final-mdm">
				<!-- MDM -->
				<td>MDM</td>
				<td class="mdm_level-1">Straightforward</td>
				<td class="mdm_level-1">Straightforward</td>
				<td class="mdm_level-2">Low Complexity</td>
				<td class="mdm_level-2">Low Complexity</td>
				<td class="mdm_level-3">Moderate</td>
				<td class="mdm_level-3">Moderate</td>
				<td class="mdm_level-4">High</td>
			</tr>
			<tr class="new-pt">
				<td>New</td>
				<td class="new_1">99201 10 min</td>
				<td class="new_2">99202 20 min</td>
				<td class="new_3"><i>Go Left</i></td>
				<td class="new_4">99203 30 min</td>
				<td class="new_5"><i>Go Left</i></td>
				<td class="new_6">99204 45 min</td>
				<td class="new_7">99205 60 min</td>
			</tr>
			<tr class="est-pt">
				<td>Est</td>
				<td class="est_1">99212 10 min</td>
				<td class="est_2"><i>Go Left</i></td>
				<td class="est_3">99213 15 min</td>
				<td class="est_4"><i>Go Left</i></td>
				<td class="est_5">99214 25 min</td>
				<td class="est_6"><i>Go Left</i></td>
				<td class="est_7">99215 40 min</td>
			</tr>
			<tr class="con-pt">
				<td>Con</td>
				<td class="con_1">99241 15 min</td>
				<td class="con_2">99242 30 min</td>
				<td class="con_3"><i>Go Left</i></td>
				<td class="con_4">99243 40 min</td>
				<td class="con_5"><i>Go Left</i></td>
				<td class="con_6">99244 60 min</td>
				<td class="con_7">99245 80 min</td>
			</tr>
		</table>

	</div>
</body>

</html>
